Evaluate CAPS

Recently, you received services from a staff member of CAPS. We would value your feedback about those visits. This form can be returned to CAPS by clicking on the "Send Button" at the bottom of this form. If you choose, you may include your name and email address in the comments section if you would like to be contacted, otherwise this form has been designed to block the identity of the sender so that your feedback will be received by CAPS anonymously.

Please click on the buttons that indicates your level of AGREEMENT with each statement.